Smith M R, Agruss N S, Levenson N I, Adolph R J
Am J Cardiol. 1975 Jan;35(1):89-96. doi: 10.1016/0002-9149(75)90564-0.
The physical findings in hypertrophic cardiomyopathy with left ventricular outflow tract obstruction are well described. In the absence of outflow tract obstruction the findings are less distinctive. There have been several reported cases in which the cardiac findings have suggested the diagnosis of mitral stenosis, In this report we describe a patient whose auscultatory and roentgenographic findings more closely mimicked mitral stenosis. The patient had a loud first heart sound, mitral opening snap and an apical presystolic murmur; left atrial enlargement was present. Noninvasive studies, including phonocardiography, echocardiography and apex cardiography, strongly suggested the correct diagnosis of nonobstructive hypertrophic cardiomyopathy. The diagnosis and unusual auscultatory findings were confirmed by results of cardiac catheterization and intracardiac phonocardiography. The importance of recognizing this syndrome and the use of noninvasive methods to establish the diagnosis are stressed.
肥厚型心肌病伴左心室流出道梗阻的体格检查结果已有详尽描述。在无流出道梗阻的情况下，这些表现则不那么具有特异性。已有数例报告称，心脏检查结果提示二尖瓣狭窄的诊断。在本报告中，我们描述了一名患者，其听诊和X线表现更酷似二尖瓣狭窄。该患者第一心音亢进、有二尖瓣开放拍击音及心尖部收缩期前杂音；存在左心房扩大。包括心音图、超声心动图和心尖搏动图在内的无创检查强烈提示非梗阻性肥厚型心肌病的正确诊断。心脏导管检查和心内心音图结果证实了诊断及异常的听诊表现。强调了认识该综合征以及使用无创方法进行诊断的重要性。
